頚髄症に対する除圧24時間後の手指運動機能は神経学的改善度の予後因子となる

Results of a 15-second Test 24 Hours after Surgery for Compression Cervical Myelopathy Predict the Final Outcome

　圧迫性脊髄症48人96手と対照(腰椎手術患者)25人50手を対象に術前，術後4時間，24時間，48時間，1週間，2週間の6時点で15秒テストを行い回数の変化を見た．頚髄症ではそれぞれ26.7，29.7，35.0，35.1，36.2，37.2(回)と24時間までに急速に増加しており，24時間値は2週間値の94％に達していた．術後24時間で獲得される手指運動回数は最大獲得回数やJOAスコア獲得点数と有意に相関しており，神経学的回復の予後因子であった．対照群では術後4時間において一時的に回数が低下していたが，頚髄症でも軽症例になるほどこの傾向が強かった．

　The early postoperative neurologic changes of cervical myelopathy patients who underwent decompression surgery were investigated by using our original 15-second test, in which the number of grips and releases with fingers that can be performed within a 15-second period is precisely counted.　The number of grip-and-release cycles before surgery, was 26.7±10.0 and 4 hours, 24 hours, 48 hours, 1 week, and 2 weeks after surgery 29.7±9.9, 35.0±11.3, 35.1±9.8, 36.2±9.6, 37.2±10.2, respectively.　The number 24 hours after surgery was 94% of the number 2 weeks after surgery.　Since the number 24 hours after surgery was significantly correlated with both the maximum gain in the number on the 15-second test and the increase in Japan Orthopaedic Association score, it can be used as a prognostic factor for eventual neurological recovery after surgery.